Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-19T12:37:18.816Z Has data issue: false hasContentIssue false

Adenoidectomy plus tympanostomy tube insertion versus adenoidectomy plus myringotomy in children with obstructive sleep apnoea syndrome

Published online by Cambridge University Press:  16 December 2010

I M Vlastos*
Affiliation:
Department of Otorhinolaryngology, Aghia Sophia Children's Hospital of Athens, Athens, Greece
M Houlakis
Affiliation:
Department of Otorhinolaryngology, Aghia Sophia Children's Hospital of Athens, Athens, Greece
D Kandiloros
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hippocration University Hospital, Athens, Greece
L Manolopoulos
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hippocration University Hospital, Athens, Greece
E Ferekidis
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hippocration University Hospital, Athens, Greece
I Yiotakis
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Hippocration University Hospital, Athens, Greece
*
Address for correspondence: Dr Ioannis M Vlastos, 26 Kirprion Agoniston, Dasos Haidariou, Athens, Greece Fax: +302105811832 E-mail: [email protected]

Abstract

Objective:

To determine whether tympanostomy tube insertion has benefit, compared with simple myringotomy, in children with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome caused by adenoid hypertrophy.

Methods:

Fifty-two children older than three years with obstructive sleep apnoea syndrome were randomly assigned to receive either adenoidectomy plus tympanostomy tube insertion (group one, n = 25) or adenoidectomy plus myringotomy (group two, n = 27). Pre- and post-operative health-related quality of life was assessed using the otitis media-6 (OM-6) tool, and audiological outcomes were recorded six and 12 months post-operatively.

Results:

Group one showed better quality of life scores six months post-operatively (score difference −0.38, confidence interval −0.65 to −0.10) but not 12 months post-operatively (score difference −0.23, confidence interval −0.76 to 0.11), compared with pre-operative values. Audiological outcomes did not differ significantly at either time point, compared with pre-operative values.

Conclusion:

Tympanostomy tube insertion confers a short term benefit, compared with simple myringotomy, in children older than three years with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome. Further studies are necessary to identify which of these children will receive long-lasting benefit from tympanostomy tube insertion.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Black, NA, Sanderson, CF, Freeland, AP, Vessey, MP. A randomised controlled trial of surgery for glue ear. BMJ 1990;300:1551–6Google Scholar
2Gates, GA, Avery, CA, Prihoda, TJ, Cooper, JC Jr.Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion. N Engl J Med 1987;317:1444–51Google Scholar
3Coyte, PC, Croxford, R, McIsaac, W, Feldman, W, Friedberg, J. The role of adjuvant adenoidectomy and tonsillectomy in the outcome of the insertion of tympanostomy tubes. N Engl J Med 2001;344:1188–95CrossRefGoogle ScholarPubMed
4Kadhim, AL, Spilsbury, K, Semmens, JB, Coates, HL, Lannigan, FJ. Adenoidectomy for middle ear effusion: a study of 50,000 children over 24 years. Laryngoscope 2007;117:427–33Google Scholar
5Lous, J, Burton, MJ, Felding, JU, Ovesen, T, Rovers, MM, Williamson, I. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev 2005:(1):CD001801CrossRefGoogle ScholarPubMed
6Hammaren-Malmi, S, Saxen, H, Tarkkanen, J, Mattila, PS. Adenoidectomy does not significantly reduce the incidence of otitis media in conjunction with the insertion of tympanostomy tubes in children who are younger than 4 years: a randomized trial. Pediatrics 2005;116:185–9CrossRefGoogle Scholar
7Paradise, JL, Bluestone, CD, Colborn, DK, Bernard, BS, Smith, CG, Rockette, HE et al. Adenoidectomy and adenotonsillectomy for recurrent acute otitis media: parallel randomized clinical trials in children not previously treated with tympanostomy tubes. JAMA 1999;282:945–53Google Scholar
8Casselbrant, ML, Mandel, EM, Rockette, HE, Kurs-Lasky, M, Fall, PA, Bluestone, CD. Adenoidectomy for otitis media with effusion in 2-3-year-old children. Int J Pediatr Otorhinolaryngol 2009;73:1718–24CrossRefGoogle ScholarPubMed
9Lous, J. Which children would benefit most from tympanostomy tubes (grommets)? A personal evidence-based review. Int J Pediatr Otorhinolaryngol 2008;72:731–6CrossRefGoogle ScholarPubMed
10Rosenfeld, RM, Bhaya, MH, Bower, CM, Brookhouser, PE, Casselbrant, ML, Chan, KH et al. Impact of tympanostomy tubes on child quality of life. Arch Otolaryngol Head Neck Surg 2000;126:585–92CrossRefGoogle ScholarPubMed
11Dempster, JH, Browning, GG, Gatehouse, SG. A randomized study of the surgical management of children with persistent otitis media with effusion associated with a hearing impairment. J Laryngol Otol 1993;107:284–9Google Scholar
12Lildholdt, T. Unilateral grommet insertion and adenoidectomy in bilateral secretory otitis media: preliminary report of the results in 91 children. Clin Otolaryngol Allied Sci 1979;4:8793Google Scholar
13Maw, AR, Bawden, R. The long term outcome of secretory otitis media in children and the effects of surgical treatment: a ten year study. Acta Otorhinolaryngol Belg 1994;48:317–24Google Scholar
14Maw, AR, Herod, F. Otoscopic, impedance, and audiometric findings in glue ear treated by adenoidectomy and tonsillectomy. A prospective randomised study. Lancet 1986;i:1399–402CrossRefGoogle Scholar
15Richards, SH, Shaw, JD, Kilby, D, Campbel, H. Grommets and glue ears: a clinical trial. J Laryngol Otol 1971;85:1722CrossRefGoogle ScholarPubMed
16To, SS, Pahor, AL, Robin, PE. A prospective trial of unilateral grommets for bilateral secretory otitis media in children. Clin Otolaryngol Allied Sci 1984;9:115–17Google Scholar
17Popova, D, Varbanova, S, Popov, TM. Comparison between myringotomy and tympanostomy tubes in combination with adenoidectomy in 3–7-year-old children with otitis media with effusion. Int J Pediatr Otorhinolaryngol 2010;74:777–80Google Scholar
18Xenellis, J, Paschalidis, J, Georgalas, C, Davilis, D, Tzagaroulakis, A, Ferekidis, E. Factors influencing the presence of otitis media with effusion 16 months after initial diagnosis in a cohort of school-age children in rural Greece: a prospective study. Int J Pediatr Otorhinolaryngol 2005;69:1641–7CrossRefGoogle Scholar
19van Balen, FA, de Melker, RA. Persistent otitis media with effusion: can it be predicted? A family practice follow-up study in children aged 6 months to 6 years. J Fam Pract 2000;49:605–11Google Scholar
20van Heerbeek, N, Akkerman, AE, Ingels, KJ, Engel, JA, Zielhuis, GA. Left-right differences in Eustachian tube function in children with ventilation tubes. Int J Pediatr Otorhinolaryngol 2003;67:861–6CrossRefGoogle ScholarPubMed
21Ruben, RJ. Randomized controlled studies and the treatment of middle-ear effusions and tonsillar pharyngitis: how random are the studies and what are their limitations? Otolaryngol Head Neck Surg 2008;139:333–9CrossRefGoogle ScholarPubMed
22Valtonen, H, Tuomilehto, H, Qvarnberg, Y, Nuutinen, J. A 14-year prospective follow-up study of children treated early in life with tympanostomy tubes: Part 1: Clinical outcomes. Arch Otolaryngol Head Neck Surg 2005;131:293–8Google Scholar